by Marion Nestle

Currently browsing posts about: CDC(Centers for Disease Control)

Apr 18 2014

CDC’s food safety report card: no happy news

The CDC has just issued its latest report on foodborne illness and food safety progress from 2006 to 2013.

It’s report has a couple of frowny faces—Campylobacter and Vibrio cases are up—and nothing else has changed.

Nothing to smile about.

Laboratory diagnoses of other foodborne microbial illnesses are also rising.

Figure: Changes in incidence of laboratory-confirmed bacterial infections, United States, 2013 compared with 2006-2008 (data are preliminary). Yersinia = 7% decrease, Vibrio = 32% increase, STEC Non-O157  = 8% increase, STEC O157 = 16% increase, Shigella = 14% decrease, Salmonella = 9% decrease, Listeria = 3% decrease, Campylobacter = 2% increase

The food industry needs to do a better job of producing safe food.

Let’s hope the new food safety rules go into effect soon and get followed.

Jan 16 2014

Congress on curbing food marketing to kids: not a chance.

Congress can’t pass a farm bill but it has plenty of time to micromanage nutrition and health.  Buried in the pork-filled Consolidated Appropriations Act of 2014 (see Monday’s post) are some zingers.  Here’s one:

appropr

This refers to the ill-fated IWG report I’ve discussed previously. To recap:

  • Congress asked the FTC to examine the effects of food marketing to children and make recommendations.
  • The FTC, USDA, FDA, and CDC got together and produced a report recommending voluntary guidelines for marketing to children based on the nutritional quality of the foods.
  • I thought the guidelines were weak in addition to being voluntary (they allowed lots of junk foods to qualify).
  • The food industry disagreed, strongly, and went to Congress to object.
  • Congress caved in to industry pressure and said the report could not be released unless the FTC produced a cost-benefit analysis.
  • End of story.
  • Why Congress feels that it’s necessary to do this again is beyond me.

I suppose we should be glad our legislators are at least doing something.

As for the food industry’s role in all this: when food companies say they are doing everything they can to reduce marketing junk foods to kids, you now know what they really mean.

Sep 9 2013

Microbiology lesson: the latest news on Cyclospora

As an undergraduate at Berkeley, I majored in Bacteriology.  I haven’t worked in that field for decades, but the training makes me appreciate the terrific job the Centers for Disease Control and Prevention (CDC) does in providing education about food safety microbiology.

The CDC website is always a good place to start (another is food safety lawyer Bill Marler’s blog).

I thought of this as I was trying to find out what’s going on with the latest big outbreak of foodborne illness, this time due to Cyclospora.

The CDC’s Cyclospora website, updated frequently, keeps track of the numbers of cases—in this case, 641 as of September 3, with 41 hospitalizations—from 24 states.

Investigators traced cases in Iowa and Nebraska to a salad mix produced by Taylor Farms de Mexico.  But this mix is not linked to cases in Texas, which complicates the investigations.

As for the biology of Cyclospora: it’s a parasitic protozoa transmitted through feces.  The CDC provides this handy diagram of its life cycle:

 

Life cycle of Cyclospora cayetanensis

What are you supposed to do to prevent getting sick from Cyclospora?  The CDC says unhelpfully: “Consumers should continue to enjoy the health benefits of eating fresh fruits and vegetables as part of a well-balanced diet.”

Everyone, it says, should follow safe produce handling recommendations.

Translation: Wash your veggies!

May 8 2012

The latest pet food Salmonella recall

A reader writes:

Here’s what I don’t understand.

Everyone who is scared of raw says they want their dog’s food to be cooked, to kill salmonella.

But here is kibble, which by definition is cooked to the point of losing most of its original nutrients, but STILL has salmonella.

I don’t see how this is possible.  If it’s cooked enough to be “kibbled,” how can it possibly still have salmonella? It just seems like the worst of all possible worlds.

This question refers to the recent recall of dry dog food manufactured by Diamond Pet Foods.

As the CDC explains, Michigan public health officials found Salmonella in an unopened bag of a Diamond kibble product during routine testing.  This particular Salmonella strain had been found to infect at least 14 people.

CDC investigators connected the dots between the illnesses and dog food through interviews:

Seven of 10 (70%) ill persons interviewed reported contact with a dog in the week before becoming ill.

Of 5 ill persons who could recall the type of dog food with which they had contact, 4 (80%) identified dry dog food produced by Diamond Pet Foods that may have been produced at a single facility in South Carolina.

In my book, Pet Food Politics: The Chihuahua in the Coal Mine, I tell the story of the massive pet food recalls of 2007 due to contamination with the industrial chemical, melamine.  And in Feed Your Pet Right, my co-authored book about the pet food industry, I explain how pet foods are manufactured and why they are so subject to contamination and recall.

Canned pet foods are sterile.  Dry kibble is not.  It may be sterile at the point of extrusion, but it is a perfect growth medium for bacteria.  It is nutritionally complete.  Although some nutrients are lost during processing, the product formulas compensate for such losses.  That is why dogs can survive on “complete and balanced” dry foods.

If the factory is contaminated with Salmonella, the bacteria can fall into the production lines and get packaged into the kibble bags.

Dogs are relatively resistant to Salmonella and usually do not show signs of illness from eating contaminated kibble.

But humans who handle the food or the dog can acquire the bacteria and get sick.

This makes dry dog food a potentially hazardous product, one best kept away from people with weak immune systems such as young children and the elderly.

People like feeding dry food to pets because it is convenient and cheap.

My point in Pet Food Politics was that pet food is an indicator of problems in food safety regulation.  If pet foods are not forced to be produced under strict food safety measures, humans and the human food supply are also at risk.

Resources

Mar 23 2012

The arguments about sodium go on and on

Dietary sodium continues to generate much talk but little action.

The CDC issued a recent Vital Signs report on dietary sodium with this graphic:

In translation from the data tables:

  • 90% of Americans consume too much salt.
  • 44% of salt comes from 10 foods: breads and rolls, cold cuts and cured meats, pizza, poultry, soups, sandwiches, cheese, pasta dishes, meat dishes, and snacks.
  • 65% of salt comes from retail processed foods.
  • 25% comes from food served at restaurants.
  • 10% comes from salt added at the table.
  • 10% occurs naturally in foods.
  • $20 billion a year is the cost of salt-related chronic disease.

The bottom line?  Americans would be better off eating less salt.

But from the standpoint of the food industry, reducing dietary sodium is a big problem.  See, for example,  FoodNavigator-USA.com‘s recent articles about sodium in foods and health:

Sodium reduction: The science, the technology… and the business case It’s expensive, risky, and difficult, but manufacturers have made huge progress on sodium reduction in recent years. But how much further can they go, and where is the ROI if consumers are at best indifferent to their efforts, or at worst downright suspicious?.. Read

Bakers on sodium reduction: We can’t afford to make products consumers won’t buy Reducing sodium is expensive and difficult, and many bakers are beginning to wonder whether it is worth investing millions into reformulating products that consumers do not want to buy, according to the Association of Bakers (ABA)… Read

Risks of slashing sodium levels in cheese could outweigh benefits, US researcher A prominent US researcher says that government pressure to cut sodium in cheese could have serious food safety, taste and labeling consequences, and questions the necessity of such a move given minimal evidence of positive health effects and muted consumer demand… Read

Sodium reduction: To boldly go… lower and lower Food manufacturers are under increasing pressure to reduce sodium, but surveys suggest many shoppers are, well, not that bothered. So where does this leave firms plugging sodium reduction solutions? Elaine Watson asks Mariano Gascon, R&D chief at seasonings, flavors and spice specialist Wixon for his take on it… Read

Law professor: Sodium reduction only works if there is a level playing field If consumers are not demanding lower-sodium products, and the government does not mandate reductions, the food industry has “no incentive to be at the forefront of change”, according to one legal expert… Read

National Dairy Council: Low sodium cheese is not taking the market by storm While cheese makers remain committed to salt reduction, demand for low-sodium cheese remains pretty lackluster, according to the National Dairy Council (NDC)… Read

Academic: Government sodium targets are incompatible with rest of dietary guidelines Further evidence that government healthy eating guidelines are more ‘aspirational’ than achievable has been uncovered by researchers testing how easy it is to meet low sodium targets and get the rest of the nutrients we need… Read

IFT urges government to take a cautious approach to sodium reduction The Institute of Food Technologists (IFT) has submitted comments to government agencies suggesting that actions to reduce sodium should not go “too far, too fast”, and has raised concerns about consumer acceptance and the safety of reduced sodium foods… Read

American Heart Association blasts industry sodium reduction skeptics Suggestions by the Salt Association and other industry associations that sodium reductions could hurt rather than improve health are “not supported by science”, the American Heart Association (AHA) has insisted… Read

‘Processed’ foods are often high in sodium – but what’s a processed food? About 75% of the sodium in our diets comes from processed foods. It’s a regularly cited figure – but what exactly is a ‘processed’ food? Consumers might be surprised… Read

But this one just in:

Mar 2 2012

How much sugar(s) do you eat?

Earlier this week I received a 3-page, single-spaced letter—plus 4 pages of charts and figures–from Andrew Briscoe III, the President and CEO of the Sugar Association.

I opened it with some trepidation because the last letter I got from the Sugar Association threatened to sue me (to read it, click here and scroll down to the Controversies section).

Whew.  This one merely expresses general concerns about:

the misinformation reported on added sugars consumption and the overstatement of added sugars contribution to increased caloric intakes.  Americans do not consume 25 percent of their calories from added sugars. We write to provide you with accurate data….

I don’t think I ever said that the average American consumes 25% of calories from sugars (although some surely do) but I have complained that the Institute of Medicine’s “safe” level of intake of sugars is 25% of calories.  This is higher than public health recommendations to restrict sugars to 10% of calories or less.  It is meant as an upper limit, but is often interpreted as a license to eat this much.

One quarter of daily calories from sugars is too high for something that provides no additional nutritional value.

The letter concludes:

The Sugar Association is committed to ensuring that all advice consumers receive regarding sugar intake is based on the best available scientific evidence and related data.  The American consumer will be better served by dietary advice that is science-based, practical and accurate, no matter the issue.

Can’t argue with that.  But as with all matters concerning nutrition, the issue is which science you choose to cite and how you interpret it.

Mr. Briscoe uses the term sugars, plural, because sucrose, HFCS, syrups, honey, and other such things are all sugars.

How much do Americans actually consume?  Mr. Briscoe was kind enough to provide USDA tables that address this question.  These describe the availability of sugars in the food supply, not necessarily what people are actually eating.

My interpretation of the tables is that they say:

  • Sugars comprise 17% of total calorie availability.
  • Adjusted for waste, the availability of sugars is about 27.5 teaspoons per day per capita (meaning everyone:  men, women, and tiny babies).
  • Translating this into calories: 27.5 teaspoons x 4 grams per teaspoon x 4 calories per gram = 440 calories per day per capita.
  • On a 2000 calorie diet, that’s 22% of total energy intake, although it will be lower for people who take in more calories.

The CDC has just released a summary of intake of added sugars among children and adolescents, in calories per day.

At 4 calories a gram, 400 calories is 100 grams or 3.5 ounces.  Can these calories contribute to weight gain or other health problems?

You bet.

As Mark Bittman put it in his New York Times column this week,

Let me state the obvious: there is no nutritional need for foods with added sugar.

All of this is part of the bigger question: How do we regulate the consumption of dangerous foods? As a nation, we’ve accepted the need to limit the marketing and availability of tobacco and alcohol. The first is dangerous in any quantity, and the second becomes dangerous when overconsumed.

And added sweeteners, experts increasingly argue, have more in common with these substances than with fruit.

No wonder the Sugar Association uses its own interpretation of the science to suggest that current levels of intake are benign and that no level of intake poses a risk.  Mr. Briscoe’s letter says:

No authoritative scientific body that has conducted a major systematic review of the scientific literature has a found a public health need to set an Upper Level (UL) for total or added sugars intake.  Every comprehensive review of the scientific literature concludes that, with the exception of dental caries, no causal link can be established between the intake of sugars and lifestyle diseases, including obesity.

I’m glad he mentioned dental caries.  Karen Sokal, a physician in California, has been tracking the onset of tooth decay among children in Latin America who are now consuming sodas and candy on a daily basis.  She writes:

Mark Bittman’s excellent editorial, “Regulating our Sugar Habit,” (Feb 27) concludes that eating too much sugar has become “the biggest public health challenge facing the developed world.”  Indeed, it poses a big health challenge for the entire world, especially developing countries.

In my 30 years of global health work, I have seen an explosion in the marketing and consumption of non-nutritious foods and beverages followed by a dramatic rise in childhood tooth decay and obesity. Quarterly business reports praise the food and beverage industry’s increased profits based on increased sales in “emerging markets.” The NY Times article on Kellogg’s purchase of Pringles (Feb 12) stated, “The snack business is growing faster and has greater appeal internationally,” which analysts noted “appears somewhat out of sync with the trends toward better-for-you snacking.”

Governmental regulations to ensure the production and marketing of healthful food and beverages must be applied worldwide and protect the health of the world’s most vulnerable populations.

Indeed, they must.  The Sugar Association has much to answer for in its opposition to public health recommendations to eat less sugar.

Jan 24 2012

Should CDC reveal the source of outbreaks? I vote yes.

Food Safety News is always an invaluable source of information about the science and politics of food safety, but today’s items are more than enough reason to subscribe immediately.

Start with Dan Flynn’s astonishing account of his repeated attempts to discover the name of the restaurant chain responsible for Salmonella outbreaks in Southern states last winter.

After calling health officials in several states where cases occurred, he says:

The surprise is not so much that public health officials do not want to name the restaurant chain involved, but that no one wants to talk about the outbreak at all…As we search for more information about this outbreak, we will do our best to follow the CDC’s own advice and provide timely and accurate information for the public.

The CDC’s report on this outbreak—and on similar ones that occurred previously—simply identify the source as “Mexican-style fast food Restaurant Chain A.”

Don’t we have the right to know the source of the outbreak so we can choose not to go there?

Food safety lawyer Bill Marler illustrates the importance of this question with an analogy:

I wonder if public health officials would have identified the actual restaurant (McDonalds) in the 1982 E. coli O157:H7 outbreak if the 1993 Jack in the Box E. coli O157:H7 outbreak would have happened?

So what’s going on here with CDC?   Again, Food Safety News comes through with an insightful explanation by Ray Costa, who works with companies on food safety issues:

When public health officials make mistakes in foodborne outbreaks, the industry suffers and the political fallout is extreme…We should not forget that local officials are closely tied to their communities in many ways.

Local health departments rely on revenue generated from the local food service industry. After many years, bonds form between local public health agencies and industry, naturally, and out of necessity.

But, he says:

In the end, honesty is the best policy during any outbreak of disease. When the investigator is guided by a careful analysis of data, an honest presentation of the facts and truthful explanation is all we can ask for…The public understands and forgives a mistake when it occurs out an abundance of caution to protect them, but there is no forgiveness for a failure to inform them and they suffer as a result.

The failure of CDC to name names is preventing the redress that victims rightfully have for damages and also reflects the power industry has to keep our investigators silent.

Food Safety News has promised to stay on this.  Its reporters are performing a great public service.

Jan 22 2012

Good news: obesity rates leveling off. But how come?

The latest obesity statistics from the Centers for Disease Control and Prevention show no change over the last several years in either adults or children.  No change is good news.

For adults in 2009-2010 the prevalence of obesity was 35.5% among men and 35.8% among women.  Obesity, in these surveys is defined as a Body Mass Index (BMI) at or greater than 30.

This represents no significant overall change compared to rates in 2003-2008.  

Going back to 1999, however, obesity rates increased significantly among men in general, and among black (non-Hispanic) and Mexican-American women in particular.  In more recent years, the rates among these groups leveled off.

 For children and adolescents in 2009-2010 the prevalence of obesity was 16.9%.  For this group, obesity is defined as a BMI at or greater than the 95th percentile of weight for height.

This represents no significant change compared to rates in 2007-2008, but with one exception: the rate of obesity among adolescent males aged 12 through 19 increased.

For decades, rates of overweight and obesity in the United States stayed about the same. But in the early 1980s, rates increased sharply and continued to increase through the 1990s.

The increases correlated closely with deregulatory policies that encouraged greater farm production and loosened restrictions on food marketing.  These led to an increase in the number of calories available in the food supply, pressures on food companies to sell those calories, a proliferation of fast food places, and marketing strategies that made it normal to drink sodas all day long, and to eat everywhere, at all times of day, and in larger portions.

Why are obesity rates leveling off now except among boys?  Nobody seems to know.

I can make up several reasons, all speculative (and I have my doubts about most of them).

  • People have gained all the weight they can and are in equilibrium
  • People are more careful about what they are eating
  • The poor economy is encouraging people to eat less
  • Junk food marketing is targeted more to boys
  • Girls are more careful about their weight
  • Boys are particularly susceptible to “eat more” marketing pressures
  • Boys are under greater psychological tension and eat to relieve it

Anyone have any better ideas?  It would be good to figure out the reason(s) as a basis for more sensible public policy.

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